Can my mechanic fix blue cars? A discussion of health clinicians' interactions with Aboriginal Australian clients

Abstract

We expect our professional mechanics to 'diagnose' and 'treat' our cars irrespective of colour, but are we expecting less from our health professionals? There is an increasing focus in the literature on health practitioner decision-making and its influence on the nature and quality of health care. In this article we explore how the basic diagnostic and therapeutic skills that health care practitioners have should be utilised equitably for all clients and propose ways this might be realised. Could the development of Indigenous specific curricula be teaching our medical students to think that Aboriginal patients are different from the norm? We conclude that despite the gains in introducing more comprehensive Aboriginal health curricula there remains considerable work to be done before we can be confident that we are ensuring that health practitioners are no longer contributing to health disparities. Key words:Aboriginal Health, Indigenous Health, health professional, racism in health, health disparities. 3 Applying ones expertise …Consider the following: if we own a car that is experiencing mechanical problems we usually would seek the advice and services of a mechanic, whose expertise in mechanics as demonstrated by their qualifications. We expect the mechanic to be able to diagnose any known mechanical problems that we, as the car owner, cannot be expected to know. We expect the mechanic to explain to us what is wrong with my car, to investigate and apply the most efficient ways of fixing the car and to be held accountable if she/he misdiagnoses or maltreats the mechanical needs of the car. We, as the owner, cannot be responsible for fixing the mechanical problems that are beyond my particular expertise and knowledge. Despite health professionals only playing a small part in the diverse factors influencing health and health care outcomes, it is useful to ask a range of questions. These questions include, could the continuing poor health of Aboriginal people be partly caused by health practitioners due to the practitioners not receiving the education required for reducing the ongoing health disparities? Could health professional's engagement with individuals and / or community also be a factor? Have practitioners not made the contribution they could or should do in this area?And, do we expect practitioners to be sufficiently skilled to substantially reduce the gap? 4 Just as we would expect a qualified mechanic to be able to repair different cars, regardless of their colour, a qualified doctor or other health professional should be able to effectively treat people from different populations with identified medical problems -regardless of their background. What if a mechanic said they could not work on your car because it is blue and

Healing Conversations: Developing a Practical Framework for Clinical Communication Between Aboriginal Communities and Healthcare Practitioners

“…This aligns with a high-context communication style [23]. Process skills can influence the quality, acceptability and outcome of clinical interactions which require attention and reflexive action as practitioners adapt their communication style to suit that of their communication partner [69,70]. Having an understanding of ones own personal communication preferences and how these may differ to others can be the beginning point for practitioners to be more attentive to processes that might be otherwise deemed insignificant.…”